This is a national database maintained by the Centers for Medicare & Medicaid Services (CMS) containing Medicare practitioners who have chosen to opt out of Medicare. The contents displayed can be narrowed by geographic location.
Use this form to reduce errors when submitting an opt-out affidavit.
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.